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September 13, 2016

Last-minute decisions before the baby arrives: Cord blood banking, SIDS monitors and circumcision

I imagine that many first-time expectant mothers think they have it all figured out as their due date approaches and then, in the last few weeks, a ton of questions pop up. Should we have hired a doula? Am I sure I want to deliver in a hospital, instead of at home? Should I write a birth plan? I can definitely relate. Here are some of the items that my husband and I have recently discussed and decided on with less than a week until my due date.

Cord Blood Banking

Cord blood banking is a procedure in which cord blood (a rich source of stem cells) is taken from a newborn's umbilical cord after delivery and preserved for possible use in the future. Why bank your child’s cord blood? According to the American Academy of Pediatrics (AAP), “umbilical cord blood has been used successfully to treat a number of genetic, blood, and cancer conditions in children such as leukemia and immune disorders.” Private cord blood banking is expensive (we’re talking thousands of dollars plus an annual storage fee), but it ensures that you will always have access to your baby’s if he or a family member should ever need it. Public cord blood banking is free, but you will not be able to receive your child’s specific cord blood stem cells in the future. The AAP does not recommend storing cord blood at private banks but encourages families to donate their baby’s cord blood to public banks to help others in need.

I looked into private cord blood banking because it seems like a good insurance policy. But after speaking with my obstetrician, my husband and I have decided not to privately bank our son’s cord blood. The chances that he or we will need it are very slim, and the expense is significant. I love the idea of donating our son’s cord blood to a public bank in the hopes that it would benefit another family. 

However, there is a catch that I had to take into consideration: my hospital’s policy is that in order to store cord blood, a baby’s umbilical cord must be clamped and cut immediately after delivery. Because of the benefits of delaying this procedure – from easier transition and breathing after delivery, to reduced anemia, to developmental advantages later in life – we are going to wait as long as possible to have our son’s umbilical cord cut, which means that we cannot donate. I found myself weighing this decision heavily, as I know other mothers have. I volunteer that this choice seems a little selfish because cord blood donations can help save lives, but my son is my priority. I want him to have the healthiest possible start to life, which means not clamping and cutting his umbilical cord until it stops pulsating.

SIDS Monitors

Sudden infant death syndrome, or SIDS, terrifies me because its exact cause is unknown. Some physical and environmental factors that may contribute to SIDS have been identified, and there are a number of risk factors that may increase its occurrence. Things like co-sleeping, side and tummy sleeping, or baby being exposed to secondhand smoke can be prevented. Other factors, like gender and age, obviously cannot. There are a number of recommendations for reducing the risk of SIDS, including always placing your baby on his back to sleep, using a firm mattress in the crib and breastfeeding. These suggestions have made a good impact on reducing SIDS, but there are still babies dying from it. Hence, my fear.

After a friend’s recommendation, my husband and I decided to purchase a SIDS monitor. I did not even know these things existed until recently. After doing some research and reading other mothers' recommendations, I discovered the Owlet. It is basically a sock that will monitor my son’s oxygen levels and heart rate while he is sleeping. If there is a decrease in either, an alarm will sound on my phone and from a base station at my bedside. The Owlet is not inexpensive, but once I knew it was available, I had to have it for my son’s safety. The American Academy of Pediatrics does not recommend using these types of monitors for SIDS prevention, but after speaking with staff at the hospital where I will deliver, I have received no reason not to invest in the Owlet. Using it will not replace following all of the recommendations to reduce SIDS, or decrease my vigilance and care for my baby, but it will provide peace of mind and perhaps prevent a tragedy.

Circumcision

I should not say that the decision to circumcise our son was a last-minute one. It is something that my husband and I decided soon after we learned that we were having a boy. At first, the choice was based on my husband’s and my personal preferences. As I have advanced in my pregnancy, I have learned that there are a lot of dissenting views and very strong negative opinions about circumcision. So, naturally, I had to do more research to determine whether or not we were making the best decision for our baby boy.

The American Academy of Pediatrics says that the benefits, like a reduced likelihood of developing sexually transmitted diseases, outweigh the risks but not enough to provide an endorsement for all baby boys to be circumcised. Parents are advised to speak with their doctors and make the decision that is right for their child. Many choose to have their sons circumcised for personal, cultural or religious reasons; many others choose not to because they believe it is unnecessary or even cruel. After speaking with our physicians and the staff at the hospital where I will deliver, and reviewing the benefits of circumcision, we have decided that we will definitely have our son circumcised, but I am glad I conducted more research in the weeks leading up to delivery to inform our choice.

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I would love to hear your thoughts on these topics and if there were any last-minute decisions that you wrestled with while you were expecting. Share with me in the comments section below, or tweet me @ThePhillyVoice and @KathleenEGagnon.

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